CREIGHTON COMMUNITY PUBLIC SCHOOL - ACTIVITIES HANDBOOK 2020-2021
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CREIGHTON
COMMUNITY PUBLIC SCHOOL
JR/SR HIGH SCHOOL
STUDENT/PARENT
ACTIVITIES HANDBOOK
2020-2021TABLE OF CONTENTS
Activity Philosophy 3
Activities Defined 3
Warning for Participants and Parents 3
Expectations of Coaches 4
Expectations of Players 4
Expectations of Parents 5
Code of Conduct 6-10
Definitions 6
Violations 6-7
Restrictions Defined 7-8
Investigative Process 8-9
Self-Reporting 9-10
Responsibility if on Restriction 10
Academic Standard 10-11
Concussion Policy 11-12
Extra-Curricular Student Eligibility 13-14
Physical Exams / Parent Permission 14
School Insurance 14
Student Absences Due to Activities/Athletics 14-15
Student Attendance and Participation 15
Student Transportation 15
Social Networking 15
Wednesday Evenings 15
Concussion Fact Sheet for Athletes 16
Concussion Fact Sheet for Parents 17
Nebraska Sports Concussion Network & ImPACT 18-19
Home Instructions for Concussed Athlete 20-21
Return to Play Parental Clearance 22
Handbook Consent Form 23
NSAA Student & Parent Consent 24
ACTIVITY PHILOSOPHY
It is the philosophy of Creighton Community Schools that activities are
an integral part of the school’s program of education, which provides
opportunities that will help students develop mentally, socially, and
physically. It is our belief that through student activities, students are
provided additional opportunities to experience success, build self-
confidence, develop self-discipline, and learn to appreciate the value of
hard work and persistence through these activities. The activity
experience contributes to the knowledge, skill, and emotional patterns
Creighton Community Schools Activities Handbook 2that they possess, thereby making them better individuals and
citizens.
Activities are considered a privilege and not the right of students.
Therefore, individuals that take part in student activities will be held to
a higher regard and are expected to demonstrate self-control, good
sportsmanship, and respect the value of competition. Participation in
activities bears with it responsibilities to the team, school, community
and to the individual themselves.
ACTIVITIES DEFINED
A wide variety of activities are currently offered and all students are
encouraged to participate provided they follow Board, State, NSAA,
and Activity guidelines. Extracurricular activities include those events
that are school sponsored, which do not count toward graduation,
grade advancement, or as a part of an academic class and which
participation is not required by the school. Examples of these events
include, but are not limited to, sports, organizations, school banquets,
music, dances, etc.
WARNING FOR PARTICIPANTS AND PARENTS
The purpose of this warning is to bring to your attention the potential
dangers associated with athletic injuries. Participation in any activity
may involve injury of some type. The severity of such injury can
range from minor cuts, bruises, sprains, and muscle strains to more
serious injuries to the body’s bones, joints, ligaments, tendons, or
muscles, to catastrophic injuries to the head, neck, and spinal cord.
On rare occasions, injuries can be so severe as to result in total
disability, paralysis or death. Even with appropriate coaching,
appropriate safety instruction, appropriate protective equipment and
observance of rules, injuries are still a possibility.
EXPECTATIONS OF COACHES
• Be a role model
• Conduct well-planned practice sessions
• Provide a safe environment
• Teach fundamentals, skills, and rules of the activity
• Develop self-confidence
• Maintain positive and effective discipline
• Demonstrate the ability to evaluate the performance of activity
participants
Creighton Community Schools Activities Handbook 3• Be knowledgeable and select appropriate strategies and tactics
• Enforce team rules in an equitable and consistent manner
• Maintain appropriate communication with students and parents
• Be able to motivate participants
• Support all activities within the school environment
• Provide constructive criticism when necessary in a positive
manner
• Cooperate with administration
• Be responsible for physical forms, eligibility lists, rosters,
transportation, uniform and equipment inventories and
requisitions, and complete all end of season material
EXPECTATIONS OF PLAYERS
• Represent the team and school in a positive manner
• Follow all school, team, and activity policies and rules
• Demonstrate proper respect for teachers, coaches, parents,
officials, teammates, and opponents
• Demonstrate proper sportsmanship and respect towards
opponents
• Demonstrate loyalty towards teammates
• Demonstrate pride and sense of caring for the program and
school as a whole
• Always give a best effort
• Effectively communicate with coaches/sponsors
• Demonstrate a positive attitude
• Follow the Academic Standard and Code of Conduct
• Be at scheduled practices and events
• Take proper care of equipment
EXPECTATIONS OF PARENTS
• Appreciate the efforts of your child
• Try your best to be completely honest about your child’s athletic
ability, competitive attitude, sportsmanship and actual skill level
• Be supportive of coaches, programs, and your child
• Teach your child to enjoy being part of an activity that has the
intention to help your child grow socially, mentally, and
physically
• Demonstrate proper sportsmanship as a spectator
Creighton Community Schools Activities Handbook 4• Always remember that children tend to exaggerate praise and
criticism, temper your reaction and investigate before
overreacting
• Maintain appropriate communication with the coach(es)
§ Appropriate concerns to discuss with coaches:
• The treatment of your child
• Ways to help your child improve
• Concerns about your child’s behavior
• Injuries or health concerns
§ Issues not appropriate to discuss with coaches:
• Playing time
• Team strategy
• Play calling
• Other student participants
§ Appropriate procedures for discussing concerns with
coaches:
• Have your child talk to the coach
• Arrange for a meeting with the coach and your child
outside of practice, games, or academic time
§ What should a parent do if the meeting with the coach did
not provide a satisfactory resolution?
• Contact the Administration and arrange a meeting
with coach, parent, and student.
• An appropriate next step can be determined, if
necessary
24-Hour Rule
The 24-Hour Rule will be utilized for any in-season communication between
parents and coaches or activity sponsors. Contact with the coaching staff or
activity sponsors and other school personnel will not be allowed until 24
hours after an athletic event. This includes coaches, sponsors,
administrators, and board members. The only exception to this rule is
reporting an injury, illness or emergency situation. Parents/fans may be
subject to dismissal from a game or multiple games for violation of the 24-
Hour Rule.
Creighton Community Schools Activities Handbook 5CODE OF CONDUCT AND ACTIVITY ELIGIBILITY
Part I: Participating and attending activities is a privilege. This
privilege carries with it responsibilities to the team, school, and
community. The students’ performance and devotion to high
standards and values make their school and community proud.
Participation is dependent upon adherence to this Code of Conduct and
the school district’s policies, procedures, and rules.
The Code of Conduct applies to all activities. Activities include, but are
not limited to: all sports, cheerleading, dance, band, vocal, speech &
drama, student council, National Honor Society, FFA, FCCLA, any
school organized clubs, dances, and/or banquets.
Participant is defined as a student that participates in an activity or
attends, has participated or attended, or will participate in or attend an
activity.
Code of Conduct rules will apply any time during the school year, and
will also include the time frame which begins with the official starting
day of the fall sports season established by the NSAA. Any infractions
at the conclusion of a school year will carry over to the following
school year.
Code of Conduct rules apply regardless of whether conduct occurs on
or off school grounds. If the conduct occurs on school grounds, at a
school function, or in a school vehicle, the student may also be subject
to additional discipline action found in the Student Handbook. Any
student suspended or expelled from attending school will not be
permitted to participate or attend activities.
Part II: The following actions and/or conduct are deemed
inappropriate for any student who wishes to represent Creighton
Schools in an extracurricular activity.
A. The possession and/or consumption of alcohol
beverages.
B. The possession and/or use of a controlled substance.
C. The possession and/or use of tobacco in any form, includes vaping.
D. Engaging in any activity which is classified as a Class
III Misdemeanor or more serious offense, as provided by the
laws of the State of Nebraska. Offenses include, but are not
limited to, assault, threats and intimidation of students
and/or faculty, shoplifting, theft, etc.
Creighton Community Schools Activities Handbook 6E. The failure to abide by the Academic Standard
F. The refusal to abide by a coach’s or sponsor’s request
concerning actions, appearance, and/or general conduct as a
representative of the Creighton Schools.
Part III, Section 1: If a thorough investigation by the Administration
establishes that a student is in violation of items A, B, or C as stated
above, or any combination of such items, the following disciplinary
action will be initiated:
A. 1st offense for an individual school year: student placed
on a 6-week restricted period
B. 2nd offense for an individual school year: student placed
under restriction for the remainder of the year to
include all activities, not a single activity season.
C. 3rd offense for an individual school year: student will be
placed on activity restriction for the remainder of the
school year or for 20 weeks, whichever is the greatest
period of time. If the activity violation occurs during
the last 20 weeks of the current school year, the
activity restriction will carry over to the next school
year.
***Under this policy, the student does not have to
be cited and/or charged by law enforcement, but to
be found, through thorough investigation by
administration, to be in the possession of alcohol,
drugs, or tobacco.
The restricted period will begin with notification from the
Principal and should run in consecutive weeks. It will
begin at midnight of the day of the violation or the day of
discovery by school officials as the case dictates, and will
end at midnight of the appropriate day.
Section 2: If a thorough investigation by the Administration
establishes that a student has been cited or charged for any
crime considered a Class III Misdemeanor or more serious, in
accordance to the Laws of the State of Nebraska, the following
disciplinary action will be taken.
A. 1st offense for an individual school year: student
placed on a 6-week restricted period
B. 2nd offense for an individual school year: student placed
Creighton Community Schools Activities Handbook 7under restriction for the remainder of the year to
include all activities, not a single activity season.
C. 3rd offense for an individual school year: student will be
placed on activity restriction for the remainder of the
school year or for 20 weeks, whichever is the greatest
period of time. If the activity violation occurs during
the last 20 weeks of the current school year, the
activity restriction will carry over to the next school
year.
***Under this policy, the student does not have to be
found guilty in the Court of Law, but cited and/or charged
for their activity.
***Committing any act which is classified as a felony by
the State of Nebraska will be considered a 2nd or 3rd
offense.
The restricted period will begin with notification from the
Principal and should run in consecutive weeks. It will
begin at midnight of the day of the violation or the day of
discovery by school officials as the case dictates, and will
end at midnight of the appropriate day.
Section 3: Failure to adhere to the Academic Standard will
result in an activity restriction further defined in the Academic
Standard rules in the Activities Handbook.
Section 4: A confirmed violation of Item (F) in Part II, is
punishable in accordance to criteria found in other appropriate
sections of the Activity Handbook, Parent/Teacher Handbook,
School Board Policy, or as developed by the various sponsors of
these extracurricular activities.
Part IV, Section 1: A thorough investigative process will be made by
Administration when it appears that a violation has occurred. The
following process will be utilized to confirm a violation.
A. The Administration will make an investigation to gather facts
about the alleged violation.
B. If the evidence suggests a student has been in violation, the
student will be provided with an oral or written notice of the
evidence against him or her and an opportunity to present
his or her version of the situation.
Creighton Community Schools Activities Handbook 8C. The Administration may restrict or suspend the student from
activities after it has been determined whether or not a
violation occurred.
D. The student and parents will be notified of the action taken.
E. If the student or parents of the student disagree with the
decision that has been made, the parents may request an
informal meeting before the Superintendent.
a. A hearing must be requested in writing within five (5)
calendar days after the parents have been notified of
the action taken.
b. Once a hearing has been requested, the hearing must
take place within five (5) calendar days upon receipt of
the hearing request, subject to extension for good
cause as determined by the Superintendent.
i. The Superintendent will notify the participants of
the time and place of the hearing in advance.
ii. The Superintendent may request additional
Administration present at the hearing or
additional individuals pertinent to the violation in
question.
c. Upon conclusion of the hearing, a written decision will
be provided to the parents within five (5) calendar
days.
d. The activity restriction, imposed by Administration, will
continue to be in effect until the hearing has been
completed and a decision has been rendered by the
Superintendent.
Section 2: The Student may be found in violation of the rules by
the following:
a. A faculty or staff member that sees and encounters a
student violating a Code of Conduct policy and reports
it to the Administration.
b. Intervention by the law or legal authorities.
c. Admission of guilt.
d. Any source deemed reliable and factual by the
Administration.
Part V, Section 1: For a first offense violation, a student has two
options that may reduce the students restricted period:
A. Come forward and confess his or her guilt to the
sponsor of the appropriate activity or administration
within three calendar days of the violation and have the
restricted time reduced to three weeks.
Creighton Community Schools Activities Handbook 9B. The student may have successful treatment for four weeks at
a treatment center for the chemically dependent or regularly
attend Alcoholics Anonymous or some verified, similar
organization for four weeks or completes the SCIP referral and
evaluation process.
Section 2: For a second offense violation, during an academic
year, the student may be reinstated after completing a 6-week
restrictive period and completing a successful treatment for four
weeks at a treatment center for the chemically dependent or
regularly attend Alcoholics Anonymous or some verified, similar
organization for four weeks or completes the SCIP referral and
evaluation process.
Section 3: If a student is cited / charged with a second
misdemeanor, as defined by the Laws of the State of Nebraska,
the student will not have the opportunity to reduce the
restriction penalty unless the charges are dropped or the student
is found innocent in the Court of Law, for one or both of the
citations.
Section 4: If a student is cited / charged with a felony, as
defined by the Laws of the State of Nebraska, the student will
not have the opportunity to reduce the restriction penalty unless
the charges are dropped or the student is found innocent in the
Court of Law.
Part VI: Should a student be placed on restriction, he or she may not
participate in any competitions, field trips, activities, or events related
to the extracurricular activity. The student may continue to attend
practices and/or meetings during the restrictive period. Activities as
part of a curricular class are not considered to be extracurricular.
ACADEMIC STANDARD
Because academics are the primary reason for attending school,
students who are failing in more than one class will be ineligible to
participate in school activities for a one-week period. Beginning the
third week of the year and the last school day of the week following,
teachers will submit names of those students who are near failing or
are failing in their classes. Those students that are failing two or more
classes will be placed on probation for one week. While on probation
or ineligible, the student, must attend a 1/2 hour per class after school
session for each class the student is failing. If the student does not
comply with the rules of probation, the student will be deemed
Creighton Community Schools Activities Handbook 10ineligible. If the student remains failing in two or more classes at the
end of the probationary week, they will be deemed ineligible in one-
week increments until they are failing fewer than two classes. A
student deemed ineligible could continue to practice but may not
participate in activity events for the following week (Monday through
Sunday). A student that is ineligible at the end of the semester will be
ineligible until the first day of the next semester.
CONCUSSION POLICY
Overview: The recognition and treatment of athletes that have a
suffered a concussion is a priority for the Creighton Community Public
Schools. In cooperation with ImPACT and the Nebraska Sports
Concussion Network, the district has implemented and developed a
concussion policy that will aid in the diagnosis and treatment of
reasonably suspected brain injuries.
Information: The district will provide information on concussions and
brain injuries to athletes and their parents or guardians prior the
beginning of practice or competition. Information may include:
1. The signs and symptoms of concussions
2. The risks posed by sustaining a concussion
3. The actions a student should take in response to sustaining a
concussion, including the notification of his or her parents.
Training: Training to recognize the symptoms of concussions and
brain injuries and how to seek their proper medical treatment shall be
made available to all coaches of the district’s athletic teams.
Suspected Concussion and Removal: A student who participates on
a school athletic team shall be removed from practice or a game when
he or she is reasonably suspected of having sustained a concussion or
brain injury in such practice or game after observation by a coach or a
licensed health care professional who is professionally affiliated with
the school.
Parent Notification: If a student is reasonably suspected after
observation of having sustained a concussion or brain injury and is
removed from an athletic activity as required above, the parent or
guardian of the student shall be notified by a coach or designee of the
date and approximate time of the injury suffered by the student, the
signs and symptoms of a concussion or brain injury that were
observed, and any actions taken to treat the student.
Creighton Community Schools Activities Handbook 11Return to Play: The injured student shall not be permitted to
participate in any school supervised team athletic activities involving
physical exertion, including, but not limited to, practices or games,
until the student:
1. Has been evaluated by a licensed health care professional,
2. Has received written and signed clearance to resume
participation in athletic activities from the licensed health care
professional,
3. Has submitted the written and signed clearance to resume
participation in athletic activities to the school accompanied by
written permission to resume participation from the student’s
parent or guardian.
The ImPACT program provides a formal return to play protocol for
athletes to return to play.
Return To Learn: The Superintendent or designee shall develop a
return to learn protocol for students who have sustained a concussion.
The return to learn protocol shall recognize that students who have
sustained a concussion and returned to school may need informal or
formal accommodations, modifications of curriculum, and monitoring
by medical or academic staff until the student is fully recovered.
Students and Parents: It is recognized that coaches cannot be aware
of every incident in which a student has symptoms of a possible
concussion or brain injury. As such, students and their parents have a
responsibility to honestly report symptoms of a possible concussion or
brain injury to the student’s coaches on a timely basis.
Legal Reference: LB 260 Concussion Awareness Act
Date of Adoption: June 11th, 2012
Creighton Community Schools Activities Handbook 12EXTRA-CURRICULAR STUDENT ELGIBILITY
The Creighton Board of Education recognizes the value of extra-
curricular activities in the overall development of our youth.
Participation in these activities is voluntary and considered a privilege
made available by the school district. The following policy emphasizes
the value of academics over activities while providing extra support for
the classroom
Requirements of Creighton Board of Education
1. Attendance at practice is required unless excused by the
coach or because of illness
2. Athletes will be neat, clean, and well groomed, and will
display personal conduct of good sportsmanship in situations
where they are representing the school.
Requirements of the NSAA/District
1. Physical examination – satisfactory medical finding must be
met (cost of the physical examination will be paid by the
student).
2. Parent/Guardian Permission
3. Insurance statement – insurance requirements must be
fulfilled.
4. Eligibility requirements – scholastic standards of association.
Eligibility requirements
1. Student must be an undergraduate.
2. Student must be enrolled in at least twenty hours per week
and in regular attendance.
3. Student must be enrolled in some high school on or before
the 11th school day of the current semester.
4. Student is ineligible if 19 yrs. of age before September 1 of
the current school year.
5. Student is ineligible if he/she has attended a four-year high
school more than 8 semesters.
6. Student must have been enrolled in school the immediate
preceding semester.
7. Student must have received 20 semester hours of credit the
immediate preceding semester.
8. Student shall not compete in any athletic contest during the
season of the sport involved either as an individual or a
member of a team unless he/she is representing his or her
school.
9. A student may not participate on an all-star team while a
high school undergraduate.
Creighton Community Schools Activities Handbook 1310.If the student is transferring from a home school and is
accepted at a member high school as a tenth, eleventh, or
twelfth grade student, he/she is considered a transfer student
and shall be ineligible for varsity competition for ninety
school days unless the home school is located in the same
school district as the high school to which the student is
transferring.
11.Those students who do not have their Enrollment Option
applications signed, filed and approved prior to March 15
shall be ineligible for 90 school days, with such transfers
being subject to hardship waiver guidelines.
12.A student shall not compete in a contest under an assumed
name.
13.A student must maintain his/her amateur status.
14.Any other eligibility guidelines, bylaws, and/or rulings made
by the NSAA.
PHYSICAL EXAMS/PARENT PERMISSION
Before a student may practice or compete in competitive
interscholastic athletics, activities sponsored by the NSAA, or
cheerleading or dance, the student must have a physical examination
administered by a licensed physician and submitted on a prescribed
form and a signed parent permission consent must be on file.
SCHOOL INSURANCE
Students are advised that the school is not financially responsible for
injuries the student may receive while participating in school activities.
Students are advised to carry an insurance plan available to them.
STUDENT ABSENCES DUE TO ACTIVITIES/ATHLETICS
Excessive student absences from classroom instruction due to
participation in extracurricular activities shall not be allowed in this
district. Occasionally, however, students may be required to miss
classroom instruction due to participation in a school-sanctioned
activity. This shall occur only when scheduling of that activity has been
approved by the school administration and advance provisions have
been made for the make-up work of class work missed during the
approved absence. Each participant of a club/activity/sport will be
allowed a maximum of five (5) days absent from school during the
school year per club/activity/sport. State competitions are exempt
from the five days allotted to each individual. Only students that
qualify for state competition will be allowed to attend. Varsity team
Creighton Community Schools Activities Handbook 14sports will only take those students on the state roster to the state
tournament. Students will not be allowed to miss consecutive full days
of school for activities without administrative approval. Absences will
be recorded in ¼ day increments.
STUDENT ATTENDANCE AND PARTICIPATION
In order to participate in any school activity, afternoon or evening, a
student must have been in class attendance for at least half of the
school day of the activity (11:42am-3:32pm). A student may be
excused for a funeral, doctor’s appointment, or other special situations
with prior Administrative approval.
STUDENT TRANSPORTATION
Students must ride the activity bus or vehicle to activities and home.
Exceptions may include:
A. Students may ride home from an activity with their parents.
The parent must see the sponsor, in person, to sign off his or
her child.
B. Students may ride home from an activity with and adult
provided that the parents have presented a note to the
administration ahead of time. The administrator must have
the note in advance of the trip so that it can be verified.
SOCIAL NETWORKING
Students who participate in extracurricular activities are particularly
vulnerable to social networking postings. It is encouraged that all
activity participants are careful about what they post or have posted
on social networking websites. What is posted on social networking
websites is public and can be accessed by others to view. Postings
have and can lead to issues, including but not limited to, discipline,
legal issues, employment, and/or scholarship eligibility.
WEDNESDAY EVENINGS
Wednesday evenings are considered family evenings. Activity
practices will conclude prior to 6 pm and participants will be given
ample time to leave the school building prior to 6:00pm. Contests will
not be scheduled on Wednesday evenings with the exception of
district, state, or unavoidable contests. No groups or clubs will be
allowed in the building after 6 pm.
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CREIGHTON COMMUNITY PUBLIC SCHOOL
Any student-athlete suspected of suffering a concussion should be removed from the game or
practice. No student-athlete may return to activity after an apparent head injury or concussion
without the written permission of a licensed health care provider and the written permission of a
parent or guardian.
_________________________
Student-Athlete Name Printed
_________________________ _____________________________ _________
Parent or Legal Guardian Printed Parent or Legal Guardian Signature Date
The above athlete has been cleared to return to play by a licensed health care provider, after
suffering a suspected head injury. My signature indicates that I understand the risks of returning
to play, after sustaining a suspected head injury. Further, my signature gives permission to the
Creighton Community Public School District and the coaching staffs of the Creighton
Community Public School District to permit my son or daughter to return to practice and
competition.
________________________________________ ___________
Student-Athlete Signature Date
My above signature indicates that I understand the risks of returning to play, after suffering a
suspected head injury. Further, my signature indicates that I would like to return to play after
evaluating and fully understanding those risks.
Creighton Community Schools Activities Handbook 22CREIGHTON COMMUNITY SCHOOLS
ACTIVITIES CONSENT PAGE
A. Activities are considered a privilege and not the right of students. Therefore, individuals that take part in student
activities will be held to a higher regard and are expected to demonstrate self-control, good sportsmanship, and
respect the value of competition. Participation in activities bears with it responsibilities to the team, school,
community and to the individual themselves.
I have accessed a copy of the Creighton Community Schools Activities Handbook. I have had the opportunity to
examine this handbook and understand its contents. I also understand that there are other board policies which
govern school operations and that the handbook is not intended to be all inclusive.
Parent/Guardian Signature: ____________________________ Date: ____________
Student Signature: ___________________________________ Date:_____________
***To access the Activity Handbook, via the Internet, please go to creightonpublicschools.org and click the
Handbook Tab on top of the screen. If you cannot access the handbook, via the Internet, copies are available
in the office.
B. I hereby acknowledge having received education about the signs, symptoms, and risks of sports related
concussions. I also acknowledge by responsibility to report any signs or symptoms of a concussion that my son or
daughter may have suffered to the coach.
Parent/Guardian Signature: ____________________________ Date: ____________
C. The school district does not purchase any type of health insurance to cover injuries incurred by your child at
school or while involved in school activities. We encourage all families to have accident coverage for their children.
My signature indicates that I/we understand the risks and potential dangers associated with participation in activities.
We feel that we have adequate insurance protection for our son/daughter or have made alternative arrangements.
Parent/Guardian Signature: ____________________________ Date: ____________
D. I understand that the Creighton Community Schools, on occasion, provides transportation for students when
attending school related activities such as, but not limited to, activities and athletic events in which my child is
involved. My signature below indicates that I give permission for my son/daughter to be transported by school
transportation for these types of activities.
Parent/Guardian Signature: ____________________________ Date: ____________
Creighton Community Schools Activities Handbook 23To be completed for
students participating in
all NSAA activities.
NEBRASKA SCHOOL ACTIVITIES ASSOCIATION (NSAA)
Student and Parent Consent Form
School Year: 20_____-20_____ Member School: _____________________________________________
Name of Student: ____________________________________________________________________
Date of Birth: ____________________ Place of Birth: _______________________________________
The undersigned(s) are the Student and the parent(s), guardian(s), or person(s) in charge of the above named Student and are
collectively referred to as "Parent”.
The Parent and Student hereby:
(1) Understand and agree that participation in NSAA sponsored activities is voluntary on the part of the Student and is a privilege;
(2) Understand and agree that (a) by this Consent Form the NSAA has provided to the Parent and Student of the existence of potential
dangers associated with athletic participation; (b) participation in any athletic activity may involve injury of some type; (c) the severity
of such injury can range from minor cuts, bruises, sprains, and muscle strains to more serious injuries to the body’s bones, joints,
ligaments, tendons, or muscles, to catastrophic injuries to the head, neck and spinal cord, and on rare occasions, injuries so severe as to
result in total disability, paralysis and death; and, (d) even the best coaching, the use of the best protective equipment and strict
observance of rules, injuries are still a possibility;
(3) Consent and agree to participation of the Student in NSAA activities subject to all NSAA by-laws and rules interpretations for
participation in NSAA sponsored activities, and the activities’ rules of the NSAA member school for which the Student is
participating; and,
(4) Consent and agree to (a) the disclosure by the Member School at which the Student is enrolled to the NSAA, and subsequent
disclosure by the NSAA, of information regarding the Student, including the student’s name, address, telephone listing, electronic
mail address, photograph, date of and place of birth, major fields of study, dates of attendance, grade level, enrollment status (e.g.,
full-time or part-time), participation in officially recognized activities and sports, weight and height as a member of athletic teams,
degrees, honors and awards received, statistics regarding performance, records or documentation related to eligibility for NSAA
sponsored activities, medical records, and any other information related to the Student’s participation in NSAA sponsored activities;
and, (b) the Student being photographed, video taped, audio taped, or recorded by any other means while participating in NSAA
activities and contests, consent to and waive any privacy rights with regard to the display of such recordings, and waive any claims of
ownership or other rights with regard to such photographs or recordings or to the broadcast, sale or display of such photographs or
recordings.
I acknowledge that I have read paragraphs (1) through (4) above, understand and agree to the terms thereof, including the warning of
potential risk of injury inherent in participation in athletic activities.
DATED this ____ day of ___________________, _____.
_________________________________ ______________________________________
Name of Student [Print Name] Student Signature
(I am)(We are) the Student’s [circle appropriate choice] (Parent) (Guardian). (I)(We) acknowledge that (I)(We) have read paragraphs
(1) through (4) above, understand and agree to the terms thereof, including the warning of potential risk of injury inherent in
participation in athletic activities. Having read the warning in paragraph (3) above and understanding the potential risk of injury to
my Student, (I)(we) hereby give (my)(our) permission for _________________[insert student name] to practice and compete for the
above named high school in activities approved by the NSAA, except those crossed out below:
Baseball Golf Tennis Play Production Basketball Swimming/Diving
Track Football Speech Cross County Soccer Volleyball
Music Unified Bowling Softball Wrestling Debate Journalism
DATED this ____ day of ___________________, _____.
________________________________ _________________________________
Parent [Print Name] Parent Signature
Revised June 2016
Creighton Community Schools Activities Handbook 24You can also read
